POC glucose results and repeat testing

Hi Lisa, our LIS sends an autogenerated report to the POC team via email each day with the list of POC glucoses performed within 10 minutes on the same patient. This report isn't very long, anywhere between 0 and 8ish glucoses per day. Then a POC coordinator (we rotate this task weekly) reviews the results to see if the patient was treated between the two glucose values. We also look at Clinical Laboratory glucose values around that time to help us determine which results we believe to be accurate. If they treated on the first glucose result, then performed a 2nd glucose result (within 10 minutes) to determine the effect of treatment - we do not credit the patient for either glucose result. If we think they performed the 2nd glucose result to verify the first result prior to treatment, we credit the patient for 1 of the glucoses.  If we think one of the glucose results was likely erroneous we credit the patient for the cost of that glucose test. We leave both results within 10 minutes of each other in the EMR unless we are told otherwise by a Pharmacist. A pharmacy team member reviews the glucoses performed across our organization daily and she will email the POC team and tell us which results are definitely erroneous and the POC team will remove the result from the EMR.  We have seen an uptick in staff performing POC glucose tests with unapproved specimen sources (earlobe, toe) and are doing re-education with trained staff on the approved POC glucose specimen types and on patient conditions where capillary whole blood is not the ideal specimen source (edema, poor peripheral perfusion etc.). Our POC team has a QA that says 95% of POC glucose results must reach the EMR within 5 minutes of when the test was performed, so we wouldn't be able to hold results in Telcor because of this and due to an insulin dosing software connected to our EMR. But this was neat to learn that Telcor could do such a thing! 

Lisa, Yes we use that protocol to hold results.  If the results do not match we do a chart review to see if they perhaps had been given d50.  Sometimes we find that if the two results do not match it is the wrong patient or the first result may be contaminated.  We also find when we investigate that a capillary specimen was not the specimen of choice due to low blood pressure, poor circulation or they are on vasopressors.  Telcor is great and it helps us catch results we need to follow up on.